Outcomes of pregnancy in women with congenital heart disease: a single center experience in Korea.
Pregnancy outcomes in patients with congenital heart disease have not been fully assessed in Korea. Forty-nine pregnancies that occurred in 34 women with congenital heart disease who registered at our hospital between September 1995 and April 2006 were reviewed. Spontaneous abortions occurred in two pregnancies at 6+1 and 7 weeks, and another two underwent elective pregnancy termination. One maternal death in puerperium occurred in a woman with Eisenmenger syndrome. Maternal cardiac complications were noted in 18.4%, pulmonary edema in 16.3%, symptomatic arrhythmia in 6.1%, deterioration of New York Heart Association (NYHA) functional class by >or=2 in 2.0%, and cardiac death in 2.0%. Independent predictors of adverse maternal cardiac events were an NYHA functional class of >or=3 (odds ratio [OR], 20.3), right ventricular dilation (OR, 21.2), and pulmonary hypertension (OR, 21.8). Neonatal complications occurred in 22.4% of pregnancies and included preterm delivery (16.3%), small for gestational age (12.2%), and neonatal death (2.0%). Independent predictors of adverse neonatal events were pulmonary hypertension (OR, 6.8) and NYHA functional class>or=3 (OR, 23.0). Pregnancy in women with congenital heart disease was found to be significantly associated with maternal cardiac and neonatal complications. Pre-pregnancy counseling and multidisciplinary care involving cardiologists and obstetricians are recommended for women with congenital heart disease contemplating pregnancy.
Song
Young Bin
YB
Department of Medicine, Sungkyunkwan University School of Medicine, Grown-Up Congenital Heart Disease Clinic, Cardiac and Vascular Center, Samsung Medical Center, Seoul, Korea.
Park
Seung Woo
SW
Kim
Jun Hyung
JH
Shin
Dae-Hee
DH
Cho
Sung Won
SW
Choi
Jin-Oh
JO
Lee
Sang-Chol
SC
Moon
Ju Ryoung
JR
Huh
June
J
Kang
I-Seok
IS
Lee
Heung Jae
HJ
D000022:Abortion, Spontaneous; D000328:Adult; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D007723:Korea; D015999:Multivariate Analysis; D009774:Obstetrics / Q000379:methods; D016017:Odds Ratio; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000503:physiopathology; D011256:Pregnancy Outcome